Dartmouth has a unique environment for creating a Multipurpose Clinical Research Center (MCRC). We have long had an active clinical research program, primarily associated with two well-established interdepartmental centers in outcomes research and cancer, which feature internationally recognized programs in medical care epidemiology and cancer chemoprevention. As Dartmouth's research base has grown, new opportunities have arisen to extend our expertise to NIAMS-related disease areas including management of low back pain, osteoporosis prevention and treatment, management of pain in clinical practice, new diagnostic imaging methods for arthritis, outcomes of arthroplasty, and therapeutic interventions for autoimmune disease. The infrastructure in biostatistics and outcomes measurement developed for our existing clinical research programs and the initiation of a major NIAMS-sponsored multi-center clinical trial for patient outcomes in surgery for low back pain together provide a unique opportunity to create a new MCRC at Dartmouth. To establish an MCRC at Dartmouth, we propose a planning process that will take full advantage of the experience of our established centers and their associated faculty in many clinical departments and the School of Engineering. Our specific aims are to develop a structure to identify and prioritize potential projects that foster and maximize interdisciplinary clinical research initiatives; to provide a forum to foster synergy between existing research programs; and to advance at least three highly meritorious projects in a completed MCRC proposal.